Association of hypertension and long-term blood pressure changes with new-onset diabetes in the elderly: A 10-year cohort study.

IF 5.4 2区医学 Q1 ENDOCRINOLOGY & METABOLISM Diabetes, Obesity & Metabolism Pub Date : 2024-10-01 DOI:10.1111/dom.15986

Shanshan Li, Boyi Yang, Shasha Shang, Wei Jiang

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Abstract

Aim: To explore the correlation between new-onset diabetes (NOD), hypertension and blood pressure management among elderly individuals in China.

Materials and methods: A cohort analysis involved 1380 participants aged 60 years or older, initially free of diabetes in 2008, from the Chinese Longitudinal Healthy Longevity Survey. Follow-up assessments occurred every 2-3 years. The relationship between hypertension, blood pressure changes and NOD was analysed using multivariable-adjusted Cox regression.

Results: By 2018, 102 participants developed diabetes, while 1278 remained without diabetes. The cumulative diabetes prevalence increased from 3.1% at 3 years to 7.4% at 10 years. Hypertension prevalence increased from 20.9% at baseline to 41.0% at 10 years, with higher rates in those diagnosed with diabetes during follow-up. Multivariate analysis identified age, gender, baseline hypertension and systolic blood pressure (SBP) as independent predictors of NOD. Hypertension combined with overweight/obesity significantly increased the risk of NOD (hazard ratio [HR] 2.837; 95% confidence interval [CI], 1.680-4.792). We evaluated participants' blood pressure management levels in 2008 and 2011, then tracked the onset of diabetes from 2011 to 2018. Compared with participants with an average SBP below 120 mmHg in 2008 and 2011, those with SBP of 140 mmHg or higher had an 8-fold higher risk of developing NOD (adjusted HR8.492, 95% CI 2.048-35.217, P = .003), the highest risk group. Participants with SBP of 130-139.9 mmHg also had a significantly increased risk (adjusted HR 5.065, 95% CI 1.186-21.633, P = .029), while those with SBP of 120-129.9 mmHg showed no significant difference (HR 2.730, 95% CI 0.597-12.481, P = .195). Consistently high SBP (≥ 130 mmHg) further increased NOD risk (adjusted HR 3.464, 95% CI 1.464-8.196, P = .005).

Conclusions: Significant predictors of NOD included age, gender, baseline hypertension and blood pressure management. Maintaining SBP consistently below 130 mmHg may be an effective strategy to reduce the incidence of NOD in the general elderly population.

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老年人高血压和长期血压变化与新发糖尿病的关系：一项为期 10 年的队列研究。

目的：探讨中国老年人新发糖尿病（NOD）、高血压和血压管理之间的相关性：对中国健康长寿纵向调查中 1380 名 60 岁及以上、2008 年初步未患糖尿病的参与者进行队列分析。随访评估每 2-3 年进行一次。采用多变量调整 Cox 回归分析了高血压、血压变化和 NOD 之间的关系：到 2018 年，102 名参与者患上了糖尿病，而 1278 名参与者仍未患上糖尿病。累计糖尿病患病率从 3 年时 3.1%增至 10 年时 7.4%。高血压患病率从基线时的20.9%增至10年时的41.0%，在随访期间确诊为糖尿病的人群中高血压患病率更高。多变量分析发现，年龄、性别、基线高血压和收缩压（SBP）是预测 NOD 的独立因素。高血压合并超重/肥胖会显著增加罹患 NOD 的风险（危险比 [HR] 2.837；95% 置信区间 [CI]，1.680-4.792）。我们评估了参与者在2008年和2011年的血压管理水平，然后追踪了2011年至2018年的糖尿病发病情况。与 2008 年和 2011 年平均 SBP 低于 120 mmHg 的参与者相比，SBP 为 140 mmHg 或更高的参与者罹患 NOD 的风险高出 8 倍（调整后 HR8.492，95% CI 2.048-35.217，P = .003），属于最高风险组。SBP 为 130-139.9 mmHg 的参与者的风险也显著增加（调整后 HR 5.065，95% CI 1.186-21.633，P = .029），而 SBP 为 120-129.9 mmHg 的参与者则无显著差异（HR 2.730，95% CI 0.597-12.481，P = .195）。持续的高 SBP（≥ 130 mmHg）进一步增加了 NOD 风险（调整后 HR 3.464，95% CI 1.464-8.196，P = .005）：NOD的重要预测因素包括年龄、性别、基线高血压和血压管理。将 SBP 保持在 130 mmHg 以下可能是降低普通老年人 NOD 发病率的有效策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes, Obesity & Metabolism 医学-内分泌学与代谢

CiteScore

10.90

自引率

6.90%

发文量

319

审稿时长

3-8 weeks

期刊介绍： Diabetes, Obesity and Metabolism is primarily a journal of clinical and experimental pharmacology and therapeutics covering the interrelated areas of diabetes, obesity and metabolism. The journal prioritises high-quality original research that reports on the effects of new or existing therapies, including dietary, exercise and lifestyle (non-pharmacological) interventions, in any aspect of metabolic and endocrine disease, either in humans or animal and cellular systems. ‘Metabolism’ may relate to lipids, bone and drug metabolism, or broader aspects of endocrine dysfunction. Preclinical pharmacology, pharmacokinetic studies, meta-analyses and those addressing drug safety and tolerability are also highly suitable for publication in this journal. Original research may be published as a main paper or as a research letter.